Getting drunk may take more of a toll on sleep for women than men, according to a polysomnography experiment.

Action Points

Explain that normal female volunteers consuming a high level of alcohol or placebo showed significant objective sleep disturbance on polysomnography compared with male volunteers whose sleep patterns did not differ markedly based on what they drank.

Note that the differences between the sexes were not affected by a family history of alcoholism.

Getting drunk may take more of a toll on sleep for women than men, according to a polysomnography experiment.

After getting intoxicated, women got less sleep and less quality sleep compared with nights after drinking a nonalcoholic placebo whereas men showed no difference across nights, J. Todd Arnedt, PhD, of the University of Michigan in Ann Arbor, and colleagues found.

"Women may be at particular risk for experiencing the next-day impairing effects of alcohol that are due to sleepiness," they wrote online in Alcoholism: Clinical and Experimental Research.

But the effect could actually be a plus in some respects.

"It is tempting to speculate that the greater alcohol-related sleep disruption could serve as a protective factor against problem drinking in young women," Arnedt's group noted in the paper.

They chalked the gender difference up to variances in the way women and men metabolize alcohol rather than greater experience with alcohol among men, which was not the case in the study.

Nevertheless, the gender difference was small in magnitude in the healthy young people tested, who were "self-described good sleepers," the researchers noted.

Moreover, the vast majority of participants correctly guessed whether they were getting alcohol or not despite attempts to double-blind the study, leaving open the possibility that the results may reflect a psychological rather than a physiological effect of alcohol.

The study included 93 healthy young adults in their 20s, of whom 59 were women and 29 had a family history of alcoholism. The participants were randomized to drink under carefully controlled conditions either:

A sex- and weight-adjusted dose of alcohol to achieve a peak breath alcohol concentration of about 0.11 g/100 dL (0.11 g%) -- the rough equivalent of having about six standard drinks.

A placebo with a few drops of alcohol floated on top for masking purposes.

After drinking the study beverage one to 2.5 hours before bedtime, the participants' sleep was monitored. One week later, the process was repeated with the opposite beverage for each individual.

Polysomnography showed that sleep was objectively disrupted more in women than in men.

After drinking alcohol, women got 20 minutes less total sleep time, had 4% lower sleep efficiency, and spent 15 minutes more time awake during the night compared with nights after drinking the placebo.

Men showed little change across the nights, and thus differed from women for total sleep time (P<0.05), sleep efficiency (P<0.01), number of awakenings (P<0.05), and time spent awake after sleep onset (P<0.01).

While alcohol's effect on sleep typically changes during the night as it switches from a sedative to a stimulant for the body, this didn't differ between men and women.

Subjective sleep quality as rated in the morning after waking up was poorer with alcohol (P<0.001) but without a difference by gender.

Alcohol also led to higher sleepiness scores overall both before bed and in the morning (all P<0.001), particularly for women. Women had higher score on the Stanford Sleepiness Scale at bedtime following alcohol compared with men (P<0.04).

None of the effects differed by family history of alcoholism.

Limitations of the study included lack of successful blinding to the beverage, absence of matching for sex or family history of alcoholism which could lead to unmeasured confounders when analyzing these characteristics, and lack of generalizability with normal, young, primarily Caucasian volunteers.

The study was supported by grants from the National Institute on Alcohol Abuse and Alcoholism and the National Center for Research Resources.

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